Definition

Fundoplication is surgery to wrap the upper stomach around the lower esophagus. It reduces the amount of acid that enters the esophagus from the stomach. Laparoscopic procedures use small incisions rather than the large incisions that are used during open surgery.

What to Expect

Prior to Procedure

X-ray
with contrast—to assess the level of reflux and evidence of damage

Endoscopy
—use of a tube attached to a viewing device called an endoscope to examine the inside of the lining of the esophagus and stomach;
a
biopsy
may also be taken

Manometry—a test to measure the muscular contractions inside the esophagus and its response to swallowing

Leading up to the surgery:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.

Arrange for a ride to and from the hospital. Also, arrange for help at home.

The night before, eat a light meal. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia
will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

Laparoscopic Procedure

A small incision will be made. A laparoscope is a small tool with a camera on the end. It will be inserted into the abdomen. It will allow the doctor to view the inside of the body on a video screen. Gas will be pumped into the abdomen to improve the view. Other small incisions will be made in the skin. Small surgical instruments will be inserted. The stomach will then be wrapped around the esophagus. If needed, any hernia will be repaired.

In some cases, the doctor may need to switch to an
open surgery
. A wide incision in the abdomen will be made to do the surgery.

How Long Will It Take?

2-4 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

2 days or more, depending on your condition

Post-procedure Care

At the Hospital

After surgery, you can expect the following:

Walk with assistance the day after surgery.

You will start by eating a liquid diet. You will slowly be able to eat more solid foods.

After a successful fundoplication, you may no longer need to take medications for GERD.

It will take about 2 weeks to recover.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

Washing their hands

Wearing gloves or masks

Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

Washing your hands often and reminding visitors and healthcare providers to do the same

Reminding your healthcare providers to wear gloves or masks

Not allowing others to touch your incision

Call Your Doctor

Call your doctor if any of these occur:

Signs of infection, including fever and chills

Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site

Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital

Increased swelling or pain in the abdomen

Difficulty swallowing that does not improve

Pain that you cannot control with the medications you have been given

Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine

Cough, shortness of breath, or chest pain

Any other new symptoms

If you think you are having an emergency, call for emergency medical services right away.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

7/30/2012 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Niebisch S, Fleming F, et al. Perioperative risk of laparoscopic fundoplication: safer than previously reported—analysis of the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2009.
American College of Surgeons.
2012(215);61-68.